SB1161 Summary

• Authorizes the Oklahoma Health Care Authority to employ one program integrity auditor for every $100 million in state and federal Medicaid funds expended if return on investment exceeds total employment costs.

• Program integrity auditors exempt from state full-time equivalent (FTE) employment limitations and tasked with conducting prepayment reviews, postpayment audits, and corrective actions.

• Defines "error rate" as mistakes based on clearly defined objective documentation standards with annual training provided to providers by the Authority.

• Requires reporting of suspected fraudulent errors to the Oklahoma Attorney General and establishes provider appeal rights through administrative law judge hearings before overpayment recoupment.

• Effective November 1, 2012.